Pub Date : 2024-06-06DOI: 10.1186/s13293-024-00624-0
Anil Sakamuri, Bruna Visniauskas, Isabella Kilanowski-Doroh, Alexandra B McNally, Ariane Imulinde, Anne Kamau, Divya Sengottaian, John McLachlan, Montserrat Anguera, Franck Mauvais-Jarvis, Sarah H Lindsey, Benard O Ogola
Background: Sex hormones and sex chromosomes play a vital role in cardiovascular disease. Testosterone plays a crucial role in men's health. Lower testosterone level is associated with cardiovascular and cardiometabolic diseases, including inflammation, atherosclerosis, and type 2 diabetes. Testosterone replacement is beneficial or neutral to men's cardiovascular health. Testosterone deficiency is associated with cardiovascular events. Testosterone supplementation to hypogonadal men improves libido, increases muscle strength, and enhances mood. We hypothesized that sex chromosomes (XX and XY) interaction with testosterone plays a role in arterial stiffening.
Methods: We used four core genotype male mice to understand the inherent contribution of sex hormones and sex chromosome complement in arterial stiffening. Age-matched mice were either gonadal intact or castrated at eight weeks plus an additional eight weeks to clear endogenous sex hormones. This was followed by assessing blood pressure, pulse wave velocity, echocardiography, and ex vivo passive vascular mechanics.
Results: Arterial stiffening but not blood pressure was more significant in castrated than testes-intact mice independent of sex chromosome complement. Castrated mice showed a leftward shift in stress-strain curves and carotid wall thinning. Sex chromosome complement (XX) in the absence of testosterone increased collagen deposition in the aorta and Kdm6a gene expression.
Conclusion: Testosterone deprivation increases arterial stiffening and vascular wall remodeling. Castration increases Col1α1 in male mice with XX sex chromosome complement. Our study shows decreased aortic contractile genes in castrated mice with XX than XY sex chromosomes.
背景:性激素和性染色体在心血管疾病中起着至关重要的作用。睾酮对男性健康起着至关重要的作用。睾酮水平降低与心血管和心脏代谢疾病有关,包括炎症、动脉粥样硬化和 2 型糖尿病。睾酮替代对男性心血管健康有益或无益。睾酮缺乏与心血管事件有关。性腺功能低下的男性补充睾酮可提高性欲、增强肌肉力量并改善情绪。我们假设性染色体(XX 和 XY)与睾酮的相互作用在动脉僵化中发挥作用:我们使用四种核心基因型雄性小鼠来了解性激素和性染色体互补在动脉僵化中的内在作用。年龄匹配的小鼠要么性腺完好无损,要么在八周时被阉割,再经过八周清除内源性性激素。随后对血压、脉搏波速度、超声心动图和体内外被动血管力学进行评估:结果:与性染色体互补无关,阉割小鼠的动脉僵化比睾丸未受损的小鼠更明显,但血压却不明显。阉割小鼠的应力-应变曲线左移,颈动脉壁变薄。在没有睾酮的情况下,性染色体互补(XX)增加了主动脉中胶原蛋白的沉积和Kdm6a基因的表达:结论:睾酮剥夺会增加动脉僵化和血管壁重塑。阉割会增加具有 XX 性染色体互补的雄性小鼠的 Col1α1。我们的研究显示,性染色体为 XX 的阉割小鼠的主动脉收缩基因比 XY 小鼠减少。
{"title":"Testosterone deficiency promotes arterial stiffening independent of sex chromosome complement.","authors":"Anil Sakamuri, Bruna Visniauskas, Isabella Kilanowski-Doroh, Alexandra B McNally, Ariane Imulinde, Anne Kamau, Divya Sengottaian, John McLachlan, Montserrat Anguera, Franck Mauvais-Jarvis, Sarah H Lindsey, Benard O Ogola","doi":"10.1186/s13293-024-00624-0","DOIUrl":"10.1186/s13293-024-00624-0","url":null,"abstract":"<p><strong>Background: </strong>Sex hormones and sex chromosomes play a vital role in cardiovascular disease. Testosterone plays a crucial role in men's health. Lower testosterone level is associated with cardiovascular and cardiometabolic diseases, including inflammation, atherosclerosis, and type 2 diabetes. Testosterone replacement is beneficial or neutral to men's cardiovascular health. Testosterone deficiency is associated with cardiovascular events. Testosterone supplementation to hypogonadal men improves libido, increases muscle strength, and enhances mood. We hypothesized that sex chromosomes (XX and XY) interaction with testosterone plays a role in arterial stiffening.</p><p><strong>Methods: </strong>We used four core genotype male mice to understand the inherent contribution of sex hormones and sex chromosome complement in arterial stiffening. Age-matched mice were either gonadal intact or castrated at eight weeks plus an additional eight weeks to clear endogenous sex hormones. This was followed by assessing blood pressure, pulse wave velocity, echocardiography, and ex vivo passive vascular mechanics.</p><p><strong>Results: </strong>Arterial stiffening but not blood pressure was more significant in castrated than testes-intact mice independent of sex chromosome complement. Castrated mice showed a leftward shift in stress-strain curves and carotid wall thinning. Sex chromosome complement (XX) in the absence of testosterone increased collagen deposition in the aorta and Kdm6a gene expression.</p><p><strong>Conclusion: </strong>Testosterone deprivation increases arterial stiffening and vascular wall remodeling. Castration increases Col1α1 in male mice with XX sex chromosome complement. Our study shows decreased aortic contractile genes in castrated mice with XX than XY sex chromosomes.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"46"},"PeriodicalIF":4.9,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-05DOI: 10.1186/s13293-024-00620-4
Melanie A Dratva, Sarah J Banks, Matthew S Panizzon, Douglas Galasko, Erin E Sundermann
Background: Past research suggests that low testosterone levels relate to poorer cognitive function and higher Alzheimer's disease (AD) risk; however, these findings are inconsistent and are mostly derived from male samples, despite similar age-related testosterone decline in females. Both animal and human studies demonstrate that testosterone's effects on brain health may be moderated by apolipoprotein E ε4 allele (APOE-ε4) carrier status, which may explain some previous inconsistencies. We examined how testosterone relates to cognitive function in older women versus men across healthy aging and the AD continuum and the moderating role of APOE-ε4 genotype.
Methods: Five hundred and sixty one participants aged 55-90 (155 cognitively normal (CN), 294 mild cognitive impairment (MCI), 112 AD dementia) from the Alzheimer's Disease Neuroimaging Initiative (ADNI), who had baseline cognitive and plasma testosterone data, as measured by the Rules Based Medicine Human DiscoveryMAP Panel were included. There were 213 females and 348 males (self-reported sex assigned at birth), and 52% of the overall sample were APOE-ε4 carriers. We tested the relationship of plasma testosterone levels and its interaction with APOE-ε4 status on clinical diagnostic group (CN vs. MCI vs. AD), global, and domain-specific cognitive performance using ANOVAs and linear regression models in sex-stratified samples. Cognitive domains included verbal memory, executive function, processing speed, and language.
Results: We did not observe a significant difference in testosterone levels between clinical diagnostic groups in either sex, regrardless of APOE-ε4 status. Across clinical diagnostic group, we found a significant testosterone by APOE-ε4 interaction in females, such that lower testosterone levels related to worse global cognition, processing speed, and verbal memory in APOE-ε4 carriers only. We did not find that testosterone, nor its interaction with APOE-ε4, related to cognitive outcomes in males.
Conclusions: Findings suggest that low testosterone levels in older female APOE-ε4 carriers across the aging-MCI-AD continuum may have deleterious, domain-specific effects on cognitive performance. Although future studies including additional sex hormones and longitudinal cognitive trajectories are needed, our results highlight the importance of including both sexes and considering APOE-ε4 carrier status when examining testosterone's role in cognitive health.
背景:过去的研究表明,睾酮水平低与认知功能较差和阿尔茨海默病(AD)风险较高有关;然而,这些研究结果并不一致,而且大多来自男性样本,尽管女性也存在与年龄相关的睾酮下降。动物和人体研究都表明,睾酮对大脑健康的影响可能会受到载脂蛋白 E ε4等位基因(APOE-ε4)携带者身份的影响,这可能解释了之前的一些不一致之处。我们研究了睾酮与老年女性认知功能的关系,以及APOE-ε4基因型的调节作用:研究人员纳入了来自阿尔茨海默病神经影像学倡议(ADNI)的 561 名 55-90 岁参与者(155 名认知正常者(CN)、294 名轻度认知障碍者(MCI)、112 名 AD 痴呆者),这些参与者都有基线认知和血浆睾酮数据,这些数据是由基于规则的医学人类发现 MAP 小组测量的。其中有 213 名女性和 348 名男性(出生时自我报告的性别),总体样本中有 52% 是 APOE-ε4 携带者。我们在性别分层样本中使用方差分析和线性回归模型检验了血浆睾酮水平及其与 APOE-ε4 状态的交互作用与临床诊断组(CN vs. MCI vs. AD)、整体和特定领域认知能力的关系。认知领域包括言语记忆、执行功能、处理速度和语言:我们没有观察到临床诊断组之间男女睾酮水平的显著差异,与 APOE-ε4 状态无关。在不同的临床诊断组中,我们发现女性的睾酮与APOE-ε4之间存在显著的交互作用,即睾酮水平越低,APOE-ε4携带者的整体认知能力、处理速度和语言记忆力越差。我们没有发现睾酮或其与APOE-ε4的相互作用与男性的认知结果有关:研究结果表明,老年女性APOE-ε4携带者在整个衰老-MCI-AD过程中的低睾酮水平可能会对认知能力产生有害的、特定领域的影响。尽管未来的研究还需要包括更多的性激素和纵向认知轨迹,但我们的研究结果强调了在研究睾酮在认知健康中的作用时,将两性都包括在内并考虑 APOE-ε4 携带者状态的重要性。
{"title":"Low testosterone levels relate to poorer cognitive function in women in an APOE-ε4-dependant manner.","authors":"Melanie A Dratva, Sarah J Banks, Matthew S Panizzon, Douglas Galasko, Erin E Sundermann","doi":"10.1186/s13293-024-00620-4","DOIUrl":"10.1186/s13293-024-00620-4","url":null,"abstract":"<p><strong>Background: </strong>Past research suggests that low testosterone levels relate to poorer cognitive function and higher Alzheimer's disease (AD) risk; however, these findings are inconsistent and are mostly derived from male samples, despite similar age-related testosterone decline in females. Both animal and human studies demonstrate that testosterone's effects on brain health may be moderated by apolipoprotein E ε4 allele (APOE-ε4) carrier status, which may explain some previous inconsistencies. We examined how testosterone relates to cognitive function in older women versus men across healthy aging and the AD continuum and the moderating role of APOE-ε4 genotype.</p><p><strong>Methods: </strong>Five hundred and sixty one participants aged 55-90 (155 cognitively normal (CN), 294 mild cognitive impairment (MCI), 112 AD dementia) from the Alzheimer's Disease Neuroimaging Initiative (ADNI), who had baseline cognitive and plasma testosterone data, as measured by the Rules Based Medicine Human DiscoveryMAP Panel were included. There were 213 females and 348 males (self-reported sex assigned at birth), and 52% of the overall sample were APOE-ε4 carriers. We tested the relationship of plasma testosterone levels and its interaction with APOE-ε4 status on clinical diagnostic group (CN vs. MCI vs. AD), global, and domain-specific cognitive performance using ANOVAs and linear regression models in sex-stratified samples. Cognitive domains included verbal memory, executive function, processing speed, and language.</p><p><strong>Results: </strong>We did not observe a significant difference in testosterone levels between clinical diagnostic groups in either sex, regrardless of APOE-ε4 status. Across clinical diagnostic group, we found a significant testosterone by APOE-ε4 interaction in females, such that lower testosterone levels related to worse global cognition, processing speed, and verbal memory in APOE-ε4 carriers only. We did not find that testosterone, nor its interaction with APOE-ε4, related to cognitive outcomes in males.</p><p><strong>Conclusions: </strong>Findings suggest that low testosterone levels in older female APOE-ε4 carriers across the aging-MCI-AD continuum may have deleterious, domain-specific effects on cognitive performance. Although future studies including additional sex hormones and longitudinal cognitive trajectories are needed, our results highlight the importance of including both sexes and considering APOE-ε4 carrier status when examining testosterone's role in cognitive health.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"45"},"PeriodicalIF":4.9,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-30DOI: 10.1186/s13293-024-00619-x
Chunyan Li, Erum Ajmal, Khaled Alok, Keren Powell, Steven Wadolowski, Willians Tambo, Justin Turpin, Ernest Barthélemy, Yousef Al-Abed, David LeDoux
Background: The outcomes of traumatic brain injury (TBI) exhibit variance contingent upon biological sex. Although female sex hormones exert neuroprotective effects, the administration of estrogen and progesterone has not yielded conclusive results. Hence, it is conceivable that additional mediators, distinct from female sex hormones, merit consideration due to their potential differential impact on TBI outcomes. Calcitonin gene-related peptide (CGRP) exhibits sexually dimorphic expression and demonstrates neuroprotective effects in acute brain injuries. In this study, we aimed to examine sex-based variations in TBI structural and functional outcomes with respect to CGRP expression.
Methods: Male and female Sprague Dawley rats were exposed to controlled cortical impact to induce severe TBI, followed by interventions with and without CGRP inhibition. In the acute phase of TBI, the study centered on elucidating the influence of CGRP on oxidative stress, nuclear factor erythroid 2-related factor 2 (Nrf2) and endothelial nitric oxide synthase (eNOS) signaling in the peri-impact tissue. Subsequently, during the chronic phase of TBI, the investigation expanded to evaluate CGRP expression in relation to lesion volume, microvascular dysfunction, and white matter injury, as well as working and spatial memory, anxiety-like, and depression-like behaviors in subjects of both sexes.
Results: Female rats exhibited elevated levels of CGRP in the peri-impact brain tissue during both baseline conditions and in the acute and chronic phases of TBI, in comparison to age-matched male counterparts. Enhanced CGRP levels in specific brain sub-regions among female rats correlated with superior structural and functional outcomes following TBI compared to their male counterparts. CGRP inhibition induced heightened oxidative stress and a reduction in the expression of Nrf2 and eNOS in both male and female rats, with the observed alteration being more pronounced in females than in males.
Conclusions: This study marks the inaugural identification of CGRP as a downstream mediator contributing to the sexually dimorphic response observed in TBI outcomes.
{"title":"CGRP as a potential mediator for the sexually dimorphic responses to traumatic brain injury.","authors":"Chunyan Li, Erum Ajmal, Khaled Alok, Keren Powell, Steven Wadolowski, Willians Tambo, Justin Turpin, Ernest Barthélemy, Yousef Al-Abed, David LeDoux","doi":"10.1186/s13293-024-00619-x","DOIUrl":"10.1186/s13293-024-00619-x","url":null,"abstract":"<p><strong>Background: </strong>The outcomes of traumatic brain injury (TBI) exhibit variance contingent upon biological sex. Although female sex hormones exert neuroprotective effects, the administration of estrogen and progesterone has not yielded conclusive results. Hence, it is conceivable that additional mediators, distinct from female sex hormones, merit consideration due to their potential differential impact on TBI outcomes. Calcitonin gene-related peptide (CGRP) exhibits sexually dimorphic expression and demonstrates neuroprotective effects in acute brain injuries. In this study, we aimed to examine sex-based variations in TBI structural and functional outcomes with respect to CGRP expression.</p><p><strong>Methods: </strong>Male and female Sprague Dawley rats were exposed to controlled cortical impact to induce severe TBI, followed by interventions with and without CGRP inhibition. In the acute phase of TBI, the study centered on elucidating the influence of CGRP on oxidative stress, nuclear factor erythroid 2-related factor 2 (Nrf2) and endothelial nitric oxide synthase (eNOS) signaling in the peri-impact tissue. Subsequently, during the chronic phase of TBI, the investigation expanded to evaluate CGRP expression in relation to lesion volume, microvascular dysfunction, and white matter injury, as well as working and spatial memory, anxiety-like, and depression-like behaviors in subjects of both sexes.</p><p><strong>Results: </strong>Female rats exhibited elevated levels of CGRP in the peri-impact brain tissue during both baseline conditions and in the acute and chronic phases of TBI, in comparison to age-matched male counterparts. Enhanced CGRP levels in specific brain sub-regions among female rats correlated with superior structural and functional outcomes following TBI compared to their male counterparts. CGRP inhibition induced heightened oxidative stress and a reduction in the expression of Nrf2 and eNOS in both male and female rats, with the observed alteration being more pronounced in females than in males.</p><p><strong>Conclusions: </strong>This study marks the inaugural identification of CGRP as a downstream mediator contributing to the sexually dimorphic response observed in TBI outcomes.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"44"},"PeriodicalIF":4.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-17DOI: 10.1186/s13293-024-00617-z
Lucilla Crudele, Carlo De Matteis, Fabio Novielli, Ersilia Di Buduo, Stefano Petruzzelli, Alessia De Giorgi, Gianfranco Antonica, Elsa Berardi, Antonio Moschetta
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined by the presence of hepatic steatosis, detected on ultrasonography (US) imaging or histology, and at least one of criteria for Metabolic Syndrome diagnosis. Simple non-invasive tests (NITs) have been proposed as an acceptable alternative when US and biopsy are not available or feasible but have not been validated for MASLD. In this observational study, we investigated the reliability of NITs for MASLD detection and whether sex-differences in screening methods should be considered.
Methods: We included 1069 individuals (48% males and 52% females) who underwent their first clinical examination for Metabolic Syndrome in the period between January 2015 and December 2022. Liver steatosis was detected through US and anthropometric and clinical parameters were recorded.
Results: Liver steatosis was detected in 648 patients and MASLD was diagnosed in 630 subjects (355 males; 275 females). Women with MASLD showed better metabolic profile and lower prevalence of Metabolic Syndrome criteria than men. Among NITs, Fatty Liver Index (FLI) showed the best ability for detection of MASLD, with a cut-off value of 44 (AUC = 0.82). When considering the two sexes for MASLD detection via FLI, despite no substantial differences regarding FLI correlations with metabolic biomarkers except for age, women showed marked lower FLI cut-off value (32; AUC = 0.80) than men (60; AUC = 0.80).
Conclusions: In this study, we found that FLI is the best non-invasive predictor of both liver steatosis and MASLD. The finding that in women FLI cut-off value for MASLD detection is 50% lower than in men suggests the need of a sex-specific personalized program of screening and prevention of dysmetabolism-related liver diseases, despite outwardly healthy biomarkers profile.
{"title":"Fatty Liver Index (FLI) is the best score to predict MASLD with 50% lower cut-off value in women than in men.","authors":"Lucilla Crudele, Carlo De Matteis, Fabio Novielli, Ersilia Di Buduo, Stefano Petruzzelli, Alessia De Giorgi, Gianfranco Antonica, Elsa Berardi, Antonio Moschetta","doi":"10.1186/s13293-024-00617-z","DOIUrl":"10.1186/s13293-024-00617-z","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined by the presence of hepatic steatosis, detected on ultrasonography (US) imaging or histology, and at least one of criteria for Metabolic Syndrome diagnosis. Simple non-invasive tests (NITs) have been proposed as an acceptable alternative when US and biopsy are not available or feasible but have not been validated for MASLD. In this observational study, we investigated the reliability of NITs for MASLD detection and whether sex-differences in screening methods should be considered.</p><p><strong>Methods: </strong>We included 1069 individuals (48% males and 52% females) who underwent their first clinical examination for Metabolic Syndrome in the period between January 2015 and December 2022. Liver steatosis was detected through US and anthropometric and clinical parameters were recorded.</p><p><strong>Results: </strong>Liver steatosis was detected in 648 patients and MASLD was diagnosed in 630 subjects (355 males; 275 females). Women with MASLD showed better metabolic profile and lower prevalence of Metabolic Syndrome criteria than men. Among NITs, Fatty Liver Index (FLI) showed the best ability for detection of MASLD, with a cut-off value of 44 (AUC = 0.82). When considering the two sexes for MASLD detection via FLI, despite no substantial differences regarding FLI correlations with metabolic biomarkers except for age, women showed marked lower FLI cut-off value (32; AUC = 0.80) than men (60; AUC = 0.80).</p><p><strong>Conclusions: </strong>In this study, we found that FLI is the best non-invasive predictor of both liver steatosis and MASLD. The finding that in women FLI cut-off value for MASLD detection is 50% lower than in men suggests the need of a sex-specific personalized program of screening and prevention of dysmetabolism-related liver diseases, despite outwardly healthy biomarkers profile.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"43"},"PeriodicalIF":4.9,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140955638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Recent studies have shown that prenatal BPA exposure altered the transcriptome profiles of autism-related genes in the offspring's hippocampus, disrupting hippocampal neuritogenesis and causing male-specific deficits in learning. However, the sex differences in the effects of prenatal BPA exposure on the developing prefrontal cortex, which is another brain region highly implicated in autism spectrum disorder (ASD), have not been investigated.
Methods: We obtained transcriptome data from RNA sequencing analysis of the prefrontal cortex of male and female rat pups prenatally exposed to BPA or control and reanalyzed. BPA-responsive genes associated with cortical development and social behaviors were selected for confirmation by qRT-PCR analysis. Neuritogenesis of primary cells from the prefrontal cortex of pups prenatally exposed to BPA or control was examined. The social behaviors of the pups were assessed using the two-trial and three-chamber tests. The male-specific impact of the downregulation of a selected BPA-responsive gene (i.e., Sema5a) on cortical development in vivo was interrogated using siRNA-mediated knockdown by an in utero electroporation technique.
Results: Genes disrupted by prenatal BPA exposure were associated with ASD and showed sex-specific dysregulation. Sema5a and Slc9a9, which were involved in neuritogenesis and social behaviors, were downregulated only in males, while Anxa2 and Junb, which were also linked to neuritogenesis and social behaviors, were suppressed only in females. Neuritogenesis was increased in males and showed a strong inverse correlation with Sema5a and Slc9a9 expression levels, whereas, in the females, neuritogenesis was decreased and correlated with Anxa2 and Junb levels. The siRNA-mediated knockdown of Sema5a in males also impaired cortical development in utero. Consistent with Anxa2 and Junb downregulations, deficits in social novelty were observed only in female offspring but not in males.
Conclusion: This is the first study to show that prenatal BPA exposure dysregulated the expression of ASD-related genes and functions, including cortical neuritogenesis and development and social behaviors, in a sex-dependent manner. Our findings suggest that, besides the hippocampus, BPA could also exert its adverse effects through sex-specific molecular mechanisms in the offspring's prefrontal cortex, which in turn would lead to sex differences in ASD-related neuropathology and clinical manifestations, which deserves further investigation.
背景:最近的研究表明,产前暴露于双酚A会改变后代海马中自闭症相关基因的转录组图谱,破坏海马神经元的生成,导致男性特有的学习障碍。然而,产前暴露于双酚 A 对发育中的前额叶皮层(另一个与自闭症谱系障碍(ASD)高度相关的脑区)的影响的性别差异尚未得到研究:我们从RNA测序分析中获得了产前暴露于双酚A或对照组的雌雄幼鼠前额叶皮层的转录组数据,并对其进行了重新分析。通过 qRT-PCR 分析,筛选出与大脑皮层发育和社会行为相关的 BPA 反应基因进行确认。检测了产前暴露于双酚 A 或对照组的幼鼠前额叶皮层原代细胞的神经发生。使用两试验和三腔试验评估了幼鼠的社会行为。通过宫内电穿孔技术,使用 siRNA 介导的基因敲除技术,研究了选定的双酚 A 反应基因(即 Sema5a)下调对体内大脑皮层发育的雄性特异性影响:结果:因产前暴露于双酚 A 而被破坏的基因与 ASD 有关,并表现出性别特异性失调。参与神经元发生和社会行为的 Sema5a 和 Slc9a9 仅在男性中被下调,而同样与神经元发生和社会行为有关的 Anxa2 和 Junb 仅在女性中被抑制。雄性的神经发生增加,并与Sema5a和Slc9a9的表达水平呈强烈的反相关,而雌性的神经发生减少,并与Anexa2和Junb的表达水平相关。siRNA 介导的男性 Sema5a 基因敲除也会影响子宫内的大脑皮层发育。与 Anxa2 和 Junb 的下调相一致的是,只在雌性后代中观察到社交新奇性缺陷,而在雄性后代中没有观察到:这是首次研究表明,产前暴露于双酚 A 会导致 ASD 相关基因和功能的表达失调,包括大脑皮层神经元的发生和发育以及社会行为。我们的研究结果表明,除了海马体外,双酚A还可能通过后代前额叶皮层的性别特异性分子机制产生不良影响,进而导致ASD相关神经病理学和临床表现的性别差异,这值得进一步研究。
{"title":"Sex-specific impacts of prenatal bisphenol A exposure on genes associated with cortical development, social behaviors, and autism in the offspring's prefrontal cortex.","authors":"Songphon Kanlayaprasit, Thanit Saeliw, Surangrat Thongkorn, Pawinee Panjabud, Kasidit Kasitipradit, Pattanachat Lertpeerapan, Kwanjira Songsritaya, Wasana Yuwattana, Thanawin Jantheang, Depicha Jindatip, Valerie W Hu, Takako Kikkawa, Noriko Osumi, Tewarit Sarachana","doi":"10.1186/s13293-024-00614-2","DOIUrl":"10.1186/s13293-024-00614-2","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have shown that prenatal BPA exposure altered the transcriptome profiles of autism-related genes in the offspring's hippocampus, disrupting hippocampal neuritogenesis and causing male-specific deficits in learning. However, the sex differences in the effects of prenatal BPA exposure on the developing prefrontal cortex, which is another brain region highly implicated in autism spectrum disorder (ASD), have not been investigated.</p><p><strong>Methods: </strong>We obtained transcriptome data from RNA sequencing analysis of the prefrontal cortex of male and female rat pups prenatally exposed to BPA or control and reanalyzed. BPA-responsive genes associated with cortical development and social behaviors were selected for confirmation by qRT-PCR analysis. Neuritogenesis of primary cells from the prefrontal cortex of pups prenatally exposed to BPA or control was examined. The social behaviors of the pups were assessed using the two-trial and three-chamber tests. The male-specific impact of the downregulation of a selected BPA-responsive gene (i.e., Sema5a) on cortical development in vivo was interrogated using siRNA-mediated knockdown by an in utero electroporation technique.</p><p><strong>Results: </strong>Genes disrupted by prenatal BPA exposure were associated with ASD and showed sex-specific dysregulation. Sema5a and Slc9a9, which were involved in neuritogenesis and social behaviors, were downregulated only in males, while Anxa2 and Junb, which were also linked to neuritogenesis and social behaviors, were suppressed only in females. Neuritogenesis was increased in males and showed a strong inverse correlation with Sema5a and Slc9a9 expression levels, whereas, in the females, neuritogenesis was decreased and correlated with Anxa2 and Junb levels. The siRNA-mediated knockdown of Sema5a in males also impaired cortical development in utero. Consistent with Anxa2 and Junb downregulations, deficits in social novelty were observed only in female offspring but not in males.</p><p><strong>Conclusion: </strong>This is the first study to show that prenatal BPA exposure dysregulated the expression of ASD-related genes and functions, including cortical neuritogenesis and development and social behaviors, in a sex-dependent manner. Our findings suggest that, besides the hippocampus, BPA could also exert its adverse effects through sex-specific molecular mechanisms in the offspring's prefrontal cortex, which in turn would lead to sex differences in ASD-related neuropathology and clinical manifestations, which deserves further investigation.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"40"},"PeriodicalIF":7.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Sex differences exist in the prevalence and clinical manifestation of several mental disorders, suggesting that sex-specific brain phenotypes may play key roles. Previous research used machine learning models to classify sex from imaging data of the whole brain and studied the association of class probabilities with mental health, potentially overlooking regional specific characteristics.
Methods: We here investigated if a regionally constrained model of brain volumetric imaging data may provide estimates that are more sensitive to mental health than whole brain-based estimates. Given its known role in emotional processing and mood disorders, we focused on the limbic system. Using two different cohorts of healthy subjects, the Human Connectome Project and the Queensland Twin IMaging, we investigated sex differences and heritability of brain volumes of limbic structures compared to non-limbic structures, and subsequently applied regionally constrained machine learning models trained solely on limbic or non-limbic features. To investigate the biological underpinnings of such models, we assessed the heritability of the obtained sex class probability estimates, and we investigated the association with major depression diagnosis in an independent clinical sample. All analyses were performed both with and without controlling for estimated total intracranial volume (eTIV).
Results: Limbic structures show greater sex differences and are more heritable compared to non-limbic structures in both analyses, with and without eTIV control. Consequently, machine learning models performed well at classifying sex based solely on limbic structures and achieved performance as high as those on non-limbic or whole brain data, despite the much smaller number of features in the limbic system. The resulting class probabilities were heritable, suggesting potentially meaningful underlying biological information. Applied to an independent population with major depressive disorder, we found that depression is associated with male-female class probabilities, with largest effects obtained using the limbic model. This association was significant for models not controlling for eTIV whereas in those controlling for eTIV the associations did not pass significance correction.
Conclusions: Overall, our results highlight the potential utility of regionally constrained models of brain sex to better understand the link between sex differences in the brain and mental disorders.
{"title":"Modeling brain sex in the limbic system as phenotype for female-prevalent mental disorders.","authors":"Gloria Matte Bon, Dominik Kraft, Erika Comasco, Birgit Derntl, Tobias Kaufmann","doi":"10.1186/s13293-024-00615-1","DOIUrl":"10.1186/s13293-024-00615-1","url":null,"abstract":"<p><strong>Background: </strong>Sex differences exist in the prevalence and clinical manifestation of several mental disorders, suggesting that sex-specific brain phenotypes may play key roles. Previous research used machine learning models to classify sex from imaging data of the whole brain and studied the association of class probabilities with mental health, potentially overlooking regional specific characteristics.</p><p><strong>Methods: </strong>We here investigated if a regionally constrained model of brain volumetric imaging data may provide estimates that are more sensitive to mental health than whole brain-based estimates. Given its known role in emotional processing and mood disorders, we focused on the limbic system. Using two different cohorts of healthy subjects, the Human Connectome Project and the Queensland Twin IMaging, we investigated sex differences and heritability of brain volumes of limbic structures compared to non-limbic structures, and subsequently applied regionally constrained machine learning models trained solely on limbic or non-limbic features. To investigate the biological underpinnings of such models, we assessed the heritability of the obtained sex class probability estimates, and we investigated the association with major depression diagnosis in an independent clinical sample. All analyses were performed both with and without controlling for estimated total intracranial volume (eTIV).</p><p><strong>Results: </strong>Limbic structures show greater sex differences and are more heritable compared to non-limbic structures in both analyses, with and without eTIV control. Consequently, machine learning models performed well at classifying sex based solely on limbic structures and achieved performance as high as those on non-limbic or whole brain data, despite the much smaller number of features in the limbic system. The resulting class probabilities were heritable, suggesting potentially meaningful underlying biological information. Applied to an independent population with major depressive disorder, we found that depression is associated with male-female class probabilities, with largest effects obtained using the limbic model. This association was significant for models not controlling for eTIV whereas in those controlling for eTIV the associations did not pass significance correction.</p><p><strong>Conclusions: </strong>Overall, our results highlight the potential utility of regionally constrained models of brain sex to better understand the link between sex differences in the brain and mental disorders.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"42"},"PeriodicalIF":7.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-15DOI: 10.1186/s13293-024-00618-y
Ingo Winschel, Anne Willing, Jan Broder Engler, Mark Walkenhorst, Nina Meurs, Lars Binkle-Ladisch, Marcel S Woo, Lena Kristina Pfeffer, Jana K Sonner, Uwe Borgmeyer, Sven Hendrik Hagen, Benjamin Grünhagel, Janna M Claussen, Marcus Altfeld, Manuel A Friese
Background: Differences in immune responses between women and men are leading to a strong sex bias in the incidence of autoimmune diseases that predominantly affect women, such as multiple sclerosis (MS). MS manifests in more than twice as many women, making sex one of the most important risk factor. However, it is incompletely understood which genes contribute to sex differences in autoimmune incidence. To address that, we conducted a gene expression analysis in female and male human spleen and identified the transmembrane protein CD99 as one of the most significantly differentially expressed genes with marked increase in men. CD99 has been reported to participate in immune cell transmigration and T cell regulation, but sex-specific implications have not been comprehensively investigated.
Methods: In this study, we conducted a gene expression analysis in female and male human spleen using the Genotype-Tissue Expression (GTEx) project dataset to identify differentially expressed genes between women and men. After successful validation on protein level of human immune cell subsets, we assessed hormonal regulation of CD99 as well as its implication on T cell regulation in primary human T cells and Jurkat T cells. In addition, we performed in vivo assays in wildtype mice and in Cd99-deficient mice to further analyze functional consequences of differential CD99 expression.
Results: Here, we found higher CD99 gene expression in male human spleens compared to females and confirmed this expression difference on protein level on the surface of T cells and pDCs. Androgens are likely dispensable as the cause shown by in vitro assays and ex vivo analysis of trans men samples. In cerebrospinal fluid, CD99 was higher on T cells compared to blood. Of note, male MS patients had lower CD99 levels on CD4+ T cells in the CSF, unlike controls. By contrast, both sexes had similar CD99 expression in mice and Cd99-deficient mice showed equal susceptibility to experimental autoimmune encephalomyelitis compared to wildtypes. Functionally, CD99 increased upon human T cell activation and inhibited T cell proliferation after blockade. Accordingly, CD99-deficient Jurkat T cells showed decreased cell proliferation and cluster formation, rescued by CD99 reintroduction.
Conclusions: Our results demonstrate that CD99 is sex-specifically regulated in healthy individuals and MS patients and that it is involved in T cell costimulation in humans but not in mice. CD99 could potentially contribute to MS incidence and susceptibility in a sex-specific manner.
背景:女性和男性在免疫反应方面的差异导致了主要影响女性的自身免疫性疾病(如多发性硬化症)发病率的强烈性别偏见。多发性硬化症的女性发病率是男性的两倍多,因此性别是最重要的风险因素之一。然而,目前还不完全清楚哪些基因导致了自身免疫性疾病发病率的性别差异。为了解决这个问题,我们对女性和男性人体脾脏进行了基因表达分析,发现跨膜蛋白 CD99 是表达差异最大的基因之一,男性表达明显增加。据报道,CD99参与了免疫细胞的转运和T细胞的调控,但其性别特异性影响尚未得到全面研究:在这项研究中,我们利用基因型-组织表达(GTEx)项目数据集对女性和男性人类脾脏进行了基因表达分析,以确定男女之间的差异表达基因。在成功验证了人类免疫细胞亚群的蛋白质水平后,我们评估了激素对 CD99 的调控,以及它对原代人类 T 细胞和 Jurkat T 细胞中 T 细胞调控的影响。此外,我们还在野生型小鼠和 Cd99 缺失型小鼠体内进行了试验,以进一步分析 CD99 表达差异的功能性后果:结果:我们发现男性脾脏中 CD99 基因的表达高于女性,并在 T 细胞和 pDCs 表面的蛋白水平上证实了这种表达差异。体外检测和对跨性别男性样本的体内外分析表明,雄激素可能是造成这种现象的主要原因。与血液相比,脑脊液中 T 细胞的 CD99 含量更高。值得注意的是,与对照组不同,男性多发性硬化症患者脑脊液中 CD4+ T 细胞的 CD99 水平较低。相比之下,在小鼠体内,雌雄小鼠的 CD99 表达相似,Cd99 缺失的小鼠与野生型小鼠相比,对实验性自身免疫性脑脊髓炎的易感性相同。从功能上讲,CD99 在人类 T 细胞活化后会增加,并在阻断后抑制 T 细胞增殖。相应地,CD99缺失的Jurkat T细胞显示出细胞增殖和集群形成的减少,而CD99的重新引入可挽救这种情况:我们的研究结果表明,CD99 在健康人和多发性硬化症患者中具有性别特异性调控,它参与了人类 T 细胞的成本刺激,但在小鼠中却没有参与。CD99 有可能以性别特异性的方式导致多发性硬化症的发病率和易感性。
{"title":"Sex- and species-specific contribution of CD99 to T cell costimulation during multiple sclerosis.","authors":"Ingo Winschel, Anne Willing, Jan Broder Engler, Mark Walkenhorst, Nina Meurs, Lars Binkle-Ladisch, Marcel S Woo, Lena Kristina Pfeffer, Jana K Sonner, Uwe Borgmeyer, Sven Hendrik Hagen, Benjamin Grünhagel, Janna M Claussen, Marcus Altfeld, Manuel A Friese","doi":"10.1186/s13293-024-00618-y","DOIUrl":"10.1186/s13293-024-00618-y","url":null,"abstract":"<p><strong>Background: </strong>Differences in immune responses between women and men are leading to a strong sex bias in the incidence of autoimmune diseases that predominantly affect women, such as multiple sclerosis (MS). MS manifests in more than twice as many women, making sex one of the most important risk factor. However, it is incompletely understood which genes contribute to sex differences in autoimmune incidence. To address that, we conducted a gene expression analysis in female and male human spleen and identified the transmembrane protein CD99 as one of the most significantly differentially expressed genes with marked increase in men. CD99 has been reported to participate in immune cell transmigration and T cell regulation, but sex-specific implications have not been comprehensively investigated.</p><p><strong>Methods: </strong>In this study, we conducted a gene expression analysis in female and male human spleen using the Genotype-Tissue Expression (GTEx) project dataset to identify differentially expressed genes between women and men. After successful validation on protein level of human immune cell subsets, we assessed hormonal regulation of CD99 as well as its implication on T cell regulation in primary human T cells and Jurkat T cells. In addition, we performed in vivo assays in wildtype mice and in Cd99-deficient mice to further analyze functional consequences of differential CD99 expression.</p><p><strong>Results: </strong>Here, we found higher CD99 gene expression in male human spleens compared to females and confirmed this expression difference on protein level on the surface of T cells and pDCs. Androgens are likely dispensable as the cause shown by in vitro assays and ex vivo analysis of trans men samples. In cerebrospinal fluid, CD99 was higher on T cells compared to blood. Of note, male MS patients had lower CD99 levels on CD4<sup>+</sup> T cells in the CSF, unlike controls. By contrast, both sexes had similar CD99 expression in mice and Cd99-deficient mice showed equal susceptibility to experimental autoimmune encephalomyelitis compared to wildtypes. Functionally, CD99 increased upon human T cell activation and inhibited T cell proliferation after blockade. Accordingly, CD99-deficient Jurkat T cells showed decreased cell proliferation and cluster formation, rescued by CD99 reintroduction.</p><p><strong>Conclusions: </strong>Our results demonstrate that CD99 is sex-specifically regulated in healthy individuals and MS patients and that it is involved in T cell costimulation in humans but not in mice. CD99 could potentially contribute to MS incidence and susceptibility in a sex-specific manner.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"41"},"PeriodicalIF":4.9,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1186/s13293-024-00616-0
Rafiad Islam, Jordon D White, Tanzil M Arefin, Sameet Mehta, Xinran Liu, Baruh Polis, Lauryn Giuliano, Sahabuddin Ahmed, Christian Bowers, Jiangyang Zhang, Arie Kaffman
Background: Early life adversity impairs hippocampal development and function across diverse species. While initial evidence indicated potential variations between males and females, further research is required to validate these observations and better understand the underlying mechanisms contributing to these sex differences. Furthermore, most of the preclinical work in rodents was performed in adult males, with only few studies examining sex differences during adolescence when such differences appear more pronounced. To address these concerns, we investigated the impact of limited bedding (LB), a mouse model of early adversity, on hippocampal development in prepubescent and adolescent male and female mice.
Methods: RNA sequencing, confocal microscopy, and electron microscopy were used to evaluate the impact of LB and sex on hippocampal development in prepubescent postnatal day 17 (P17) mice. Additional studies were conducted on adolescent mice aged P29-36, which included contextual fear conditioning, retrograde tracing, and ex vivo diffusion magnetic resonance imaging (dMRI).
Results: More severe deficits in axonal innervation and myelination were found in the perforant pathway of prepubescent and adolescent LB males compared to LB female littermates. These sex differences were due to a failure of reelin-positive neurons located in the lateral entorhinal cortex (LEC) to innervate the dorsal hippocampus via the perforant pathway in males, but not LB females, and were strongly correlated with deficits in contextual fear conditioning.
Conclusions: LB impairs the capacity of reelin-positive cells located in the LEC to project and innervate the dorsal hippocampus in LB males but not female LB littermates. Given the critical role that these projections play in supporting normal hippocampal function, a failure to establish proper connectivity between the LEC and the dorsal hippocampus provides a compelling and novel mechanism to explain the more severe deficits in myelination and contextual freezing found in adolescent LB males.
{"title":"Early adversity causes sex-specific deficits in perforant pathway connectivity and contextual memory in adolescent mice.","authors":"Rafiad Islam, Jordon D White, Tanzil M Arefin, Sameet Mehta, Xinran Liu, Baruh Polis, Lauryn Giuliano, Sahabuddin Ahmed, Christian Bowers, Jiangyang Zhang, Arie Kaffman","doi":"10.1186/s13293-024-00616-0","DOIUrl":"10.1186/s13293-024-00616-0","url":null,"abstract":"<p><strong>Background: </strong>Early life adversity impairs hippocampal development and function across diverse species. While initial evidence indicated potential variations between males and females, further research is required to validate these observations and better understand the underlying mechanisms contributing to these sex differences. Furthermore, most of the preclinical work in rodents was performed in adult males, with only few studies examining sex differences during adolescence when such differences appear more pronounced. To address these concerns, we investigated the impact of limited bedding (LB), a mouse model of early adversity, on hippocampal development in prepubescent and adolescent male and female mice.</p><p><strong>Methods: </strong>RNA sequencing, confocal microscopy, and electron microscopy were used to evaluate the impact of LB and sex on hippocampal development in prepubescent postnatal day 17 (P17) mice. Additional studies were conducted on adolescent mice aged P29-36, which included contextual fear conditioning, retrograde tracing, and ex vivo diffusion magnetic resonance imaging (dMRI).</p><p><strong>Results: </strong>More severe deficits in axonal innervation and myelination were found in the perforant pathway of prepubescent and adolescent LB males compared to LB female littermates. These sex differences were due to a failure of reelin-positive neurons located in the lateral entorhinal cortex (LEC) to innervate the dorsal hippocampus via the perforant pathway in males, but not LB females, and were strongly correlated with deficits in contextual fear conditioning.</p><p><strong>Conclusions: </strong>LB impairs the capacity of reelin-positive cells located in the LEC to project and innervate the dorsal hippocampus in LB males but not female LB littermates. Given the critical role that these projections play in supporting normal hippocampal function, a failure to establish proper connectivity between the LEC and the dorsal hippocampus provides a compelling and novel mechanism to explain the more severe deficits in myelination and contextual freezing found in adolescent LB males.</p>","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"15 1","pages":"39"},"PeriodicalIF":4.9,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-21DOI: 10.1186/s13293-024-00609-z
Alexander Kautzky, Stephan Nopp, Dietlinde Gattinger, Milos Petrovic, Martin Antlinger, Dustin Schomacker, Alexandra Kautzky-Willer, Ralf Harun Zwick
Following years of pandemic severe acute respiratory syndrome coronavirus 2 infections labelled Covid-19, long lasting impairment summarized as post-Covid syndrome (PCS) challenges worldwide healthcare. Patients benefit from rehabilitation programs, but sex specific aspects of improvement remain little understood. The aim of the study was to assess whether women and men differ in response to outpatient pulmonary rehabilitation for PCS. 263 (54.4% female) patients partaking in outpatient pulmonary rehabilitation (OPR) due to PCS between March 2020 and July 2022 were included in a prospective observational cohort study. Outcomes were assessed at baseline and before discharge from OPR and included six-minute walking distance (6MWD), 1-second forced expiratory volume (FEV1), diffusion capacity for carbon monoxide, maximal inspiratory pressure (MIP), dyspnea (medical research council scale), and post-Covid functional status scale (PCFS). Sexspecific changes in outcomes following OPR were assessed by linear mixed model and presented as mean differences (MD) with 95% confidence intervals. Linear regression was applied to test whether 6MWD correlates with PCFS and the minimal clinically important difference (MCID) in 6MWD regarding an improvement of at least one point in PCFS was computed with logistic regression. Significant improvement throughout OPR was observed for all outcomes (all p < 0.0001). Despite less severe Covid-19 infections, PCFS scores remained higher in females after OPR (p = 0.004) and only 19.4% of women compared to 38.5% of men achieved remission of functional impairment. At baseline as well as after OPR, females showed higher symptom load compared to men in dyspnea (p = 0.0027) and scored lower in FEV1 (p = 0.009) and MIP (p = 0.0006) assessment. Performance in 6MWD was comparable between men and women. An increase of 35 m in 6MWD was computed as minimal clinically important difference to improve functional impairment. Both subjective symptoms such as fatigue and dyspnea and objective impairment in performance in pulmonary function were more frequently observed among women. Despite improvement throughout OPR in both women and men, the sex-gap in symptom load could not be closed as women less often achieved remission from functional impairment due to PCS. Intensified treatment of these symptoms should be considered in women undergoing rehabilitation for PCS. While female sex is protective during the acute infection of Covid-19, women are at increased risk of developing post-Covid syndrome (PCS) even after only mild Covid-19 infections. Severity and frequency of symptoms such as fatigue and shortness of breath are known to be higher in women compared to men. Many different rehabilitation protocols are used for PCS, but a knowledge gap regarding sex related differences in rehabilitation success remains. Both female and male patients with PCS undergoing outpatient pulmonary rehabilitation improved in the maximum walking distance achieved
{"title":"Sex differences of post-Covid patients undergoing outpatient pulmonary rehabilitation","authors":"Alexander Kautzky, Stephan Nopp, Dietlinde Gattinger, Milos Petrovic, Martin Antlinger, Dustin Schomacker, Alexandra Kautzky-Willer, Ralf Harun Zwick","doi":"10.1186/s13293-024-00609-z","DOIUrl":"https://doi.org/10.1186/s13293-024-00609-z","url":null,"abstract":"Following years of pandemic severe acute respiratory syndrome coronavirus 2 infections labelled Covid-19, long lasting impairment summarized as post-Covid syndrome (PCS) challenges worldwide healthcare. Patients benefit from rehabilitation programs, but sex specific aspects of improvement remain little understood. The aim of the study was to assess whether women and men differ in response to outpatient pulmonary rehabilitation for PCS. 263 (54.4% female) patients partaking in outpatient pulmonary rehabilitation (OPR) due to PCS between March 2020 and July 2022 were included in a prospective observational cohort study. Outcomes were assessed at baseline and before discharge from OPR and included six-minute walking distance (6MWD), 1-second forced expiratory volume (FEV1), diffusion capacity for carbon monoxide, maximal inspiratory pressure (MIP), dyspnea (medical research council scale), and post-Covid functional status scale (PCFS). Sexspecific changes in outcomes following OPR were assessed by linear mixed model and presented as mean differences (MD) with 95% confidence intervals. Linear regression was applied to test whether 6MWD correlates with PCFS and the minimal clinically important difference (MCID) in 6MWD regarding an improvement of at least one point in PCFS was computed with logistic regression. Significant improvement throughout OPR was observed for all outcomes (all p < 0.0001). Despite less severe Covid-19 infections, PCFS scores remained higher in females after OPR (p = 0.004) and only 19.4% of women compared to 38.5% of men achieved remission of functional impairment. At baseline as well as after OPR, females showed higher symptom load compared to men in dyspnea (p = 0.0027) and scored lower in FEV1 (p = 0.009) and MIP (p = 0.0006) assessment. Performance in 6MWD was comparable between men and women. An increase of 35 m in 6MWD was computed as minimal clinically important difference to improve functional impairment. Both subjective symptoms such as fatigue and dyspnea and objective impairment in performance in pulmonary function were more frequently observed among women. Despite improvement throughout OPR in both women and men, the sex-gap in symptom load could not be closed as women less often achieved remission from functional impairment due to PCS. Intensified treatment of these symptoms should be considered in women undergoing rehabilitation for PCS. While female sex is protective during the acute infection of Covid-19, women are at increased risk of developing post-Covid syndrome (PCS) even after only mild Covid-19 infections. Severity and frequency of symptoms such as fatigue and shortness of breath are known to be higher in women compared to men. Many different rehabilitation protocols are used for PCS, but a knowledge gap regarding sex related differences in rehabilitation success remains. Both female and male patients with PCS undergoing outpatient pulmonary rehabilitation improved in the maximum walking distance achieved","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"19 1","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140635138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 10.1186/s13293-024-00607-1
Wei Yang, Joshua B. Rubin
The significant sex and gender differences that exist in cancer mechanisms, incidence, and survival, have yet to impact clinical practice. One barrier to translation is that cancer phenotypes cannot be segregated into distinct male versus female categories. Instead, within this convenient but contrived dichotomy, male and female cancer phenotypes are highly overlapping and vary between female- and male- skewed extremes. Thus, sex and gender-specific treatments are unrealistic, and our translational goal should be adaptation of treatment to the variable effects of sex and gender on targetable pathways. To overcome this obstacle, we profiled the similarities in 8370 transcriptomes of 26 different adult and 4 different pediatric cancer types. We calculated the posterior probabilities of predicting patient sex and gender based on the observed sexes of similar samples in this map of transcriptome similarity. Transcriptomic index (TI) values were derived from posterior probabilities and allowed us to identify poles with local enrichments for male or female transcriptomes. TI supported deconvolution of transcriptomes into measures of patient-specific activity in sex and gender-biased, targetable pathways. It identified sex and gender-skewed extremes in mechanistic phenotypes like cell cycle signaling and immunity, and precisely positioned each patient’s whole transcriptome on an axis of continuously varying sex and gender phenotypes. Cancer type, patient sex and gender, and TI value provides a novel and patient- specific mechanistic identifier that can be used for realistic sex and gender-adaptations of precision cancer treatment planning. Some efforts to improve cancer therapy involve the idea of personalizing treatments to who a patient is and how their cancer operates. Personalizing treatment can involve straighforward features like a patient’s age, family cancer history, personal disease and surgical histories, as well as more complex features like analysis of their specific cancer’s mechanisms of growth and spread throughout the body. One glaring omission in common personalization schemes is the sex and gender of the patient. While patient sex and gender is known to substantially affect cancer rates and response to treatment, we do not yet use this information in treatment planning. There are multiple reasons for this but among them is that we tend to think about sex and gender as an either/or categorization. You are either a male/man or a female/woman. This is not accurate as there are many variables that contribute to who an individual is as a male/man or female/woman. This variability is a challenge to incorporating these features into personalized treatment planning. Here, we have developed a method to address this challenge. It is our great hope that this will enable the use of this critically important element of personalization in cancer treatment planning and improve survival rates for all patients.
癌症发病机制、发病率和存活率方面存在的重大性别差异尚未对临床实践产生影响。转化的一个障碍是,癌症表型无法划分为明显的男性和女性类别。相反,在这种方便但臆造的二分法中,男性和女性癌症表型高度重叠,并在女性和男性两个极端之间变化。因此,针对不同性别的治疗方法是不现实的,我们的转化目标应该是根据性别对可靶向途径的不同影响调整治疗方法。为了克服这一障碍,我们分析了 26 种不同成人癌症和 4 种不同儿童癌症的 8370 个转录组的相似性。我们根据转录组相似性图谱中观察到的相似样本的性别,计算了预测患者性别的后验概率。转录组指数(TI)值来自后验概率,使我们能够识别出男性或女性转录组局部富集的极点。转录组指数支持将转录组解构为衡量患者在性别和性别偏倚的目标通路中的特异性活动。它确定了细胞周期信号转导和免疫等机理表型的性别倾斜极端,并将每位患者的整个转录组精确定位在持续变化的性别表型轴上。癌症类型、患者性别和 TI 值提供了一种新颖的患者特异性机理标识符,可用于对癌症精准治疗计划进行现实的性别适应。改善癌症治疗的一些努力包括根据患者的身份及其癌症的运作方式进行个性化治疗。个性化治疗可能涉及患者的年龄、家族癌症史、个人疾病史和手术史等直接特征,以及分析特定癌症的生长和全身扩散机制等更复杂的特征。在常见的个性化方案中,一个明显的疏漏就是病人的性别。众所周知,患者的性别会对癌症发病率和治疗反应产生重大影响,但我们还没有在治疗计划中使用这些信息。造成这种情况的原因有很多,但其中之一是我们倾向于将性和性别视为非此即彼的分类。你要么是男性/男人,要么是女性/女人。这是不准确的,因为一个人是男是女有很多变数。这种可变性是将这些特征纳入个性化治疗计划的一个挑战。在此,我们开发了一种方法来应对这一挑战。我们殷切希望,这将有助于在癌症治疗规划中使用这一至关重要的个性化元素,并提高所有患者的生存率。
{"title":"Treating sex and gender differences as a continuous variable can improve precision cancer treatments","authors":"Wei Yang, Joshua B. Rubin","doi":"10.1186/s13293-024-00607-1","DOIUrl":"https://doi.org/10.1186/s13293-024-00607-1","url":null,"abstract":"The significant sex and gender differences that exist in cancer mechanisms, incidence, and survival, have yet to impact clinical practice. One barrier to translation is that cancer phenotypes cannot be segregated into distinct male versus female categories. Instead, within this convenient but contrived dichotomy, male and female cancer phenotypes are highly overlapping and vary between female- and male- skewed extremes. Thus, sex and gender-specific treatments are unrealistic, and our translational goal should be adaptation of treatment to the variable effects of sex and gender on targetable pathways. To overcome this obstacle, we profiled the similarities in 8370 transcriptomes of 26 different adult and 4 different pediatric cancer types. We calculated the posterior probabilities of predicting patient sex and gender based on the observed sexes of similar samples in this map of transcriptome similarity. Transcriptomic index (TI) values were derived from posterior probabilities and allowed us to identify poles with local enrichments for male or female transcriptomes. TI supported deconvolution of transcriptomes into measures of patient-specific activity in sex and gender-biased, targetable pathways. It identified sex and gender-skewed extremes in mechanistic phenotypes like cell cycle signaling and immunity, and precisely positioned each patient’s whole transcriptome on an axis of continuously varying sex and gender phenotypes. Cancer type, patient sex and gender, and TI value provides a novel and patient- specific mechanistic identifier that can be used for realistic sex and gender-adaptations of precision cancer treatment planning. Some efforts to improve cancer therapy involve the idea of personalizing treatments to who a patient is and how their cancer operates. Personalizing treatment can involve straighforward features like a patient’s age, family cancer history, personal disease and surgical histories, as well as more complex features like analysis of their specific cancer’s mechanisms of growth and spread throughout the body. One glaring omission in common personalization schemes is the sex and gender of the patient. While patient sex and gender is known to substantially affect cancer rates and response to treatment, we do not yet use this information in treatment planning. There are multiple reasons for this but among them is that we tend to think about sex and gender as an either/or categorization. You are either a male/man or a female/woman. This is not accurate as there are many variables that contribute to who an individual is as a male/man or female/woman. This variability is a challenge to incorporating these features into personalized treatment planning. Here, we have developed a method to address this challenge. It is our great hope that this will enable the use of this critically important element of personalization in cancer treatment planning and improve survival rates for all patients. ","PeriodicalId":8890,"journal":{"name":"Biology of Sex Differences","volume":"57 1","pages":""},"PeriodicalIF":7.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140593909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}